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"Damage control surgery"

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https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#1
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28530772/characteristics-of-the-injuries-of-syrian-refugees-sustained-during-the-civil-war
#2
Betül Kocamer Şimşek, Mehmet Dokur, Erdal Uysal, Necdet Çalıker, Oruç Numan Gökçe, İbrahim Kürşat Deniz, Murat Uğur, Murat Geyik, Mehmet Kaya, Güner Dağlı
BACKGROUND: During a war, many civilians are severely injured by firearms, bombs, and shrapnel. The triage of war injuries involves difficult and complicated processes requiring surgical procedures and patient monitoring in the Intensive Care Unit (ICU) of hospitals. In this study, we examine the demographic, traumatic, and critical care characteristics of cases injured during the civil war in Syria and requiring emergency surgery. METHODS: Electronic data of the traumatic, surgical, and ICU monitoring features of 707 patients admitted to Kilis Public Hospital between March 2012 and January 2013 were analyzed retrospectively RESULTS: Most of the patients reported having been injured due to firearms (83...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28512392/utility-of-glissonean-pedicle-transection-for-surgical-treatment-of-severe-liver-trauma
#3
Satoshi Koizumi, Kenta Katsumata, Tatsunori Ono, Kouhei Segami, Hiroyuki Hoshino, Masafumi Katayama, Shinjiro Kobayashi, Junichi Matsumoto, Shigeki Fujitani, Yasuhiko Taira, Takehito Otsubo
The most common initial strategy for treatment of severe liver trauma is damage control in which hemostasis is achieved by perihepatic gauze packing and/or vascular embolization. However, we encounter patients in whom this strategy alone is not adequate. We have applied the principles of Glissonean pedicle transection, a technique that was originally devised to ensure safe and quick performance of planned hepatectomy for liver cancer, to 3 cases of severe liver trauma. We performed Glissonean pedicle ligation during damage control surgery in 2 patients and Glissonean pedicle transection during the definitive surgery in 1 patient...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28504624/-damage-control-surgery-in-patients-with-abdominal-sepsis
#4
Nikolaj Nerup, Karen Oline Larsen Langballe, Michael P Achiam, Lars B Svendsen
Damage control surgery (DCS) and resuscitation has improved the survival of trauma patients with decompensated physiology. In recent years, the principles of DCS have been used in the treatment of patients with abdominal sepsis, despite the fact that only a minimum of evidence exists. The aim is to optimize the physiology prior to definitive surgery. This implies a primary decontaminating surgical procedure with temporary abdominal closure without restoration of the intestinal continuity and avoidance of stoma formation in order to reduce time in the operating theatre...
May 8, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28502073/early-impact-of-abdominal-compartment-syndrome-on-liver-kidney-and-lung-damage-in-a-rodent-model
#5
Ricardo Lima, Pedro L Silva, Vera L Capelozzi, Mariana G Oliveira, Maria Cristina E Santana, Fernanda F Cruz, Paolo Pelosi, Alberto Schanaider, Manu L N G Malbrain, Patricia R M Rocco
BACKGROUND: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology. METHODS: Twenty Wistar rats (mass 300-350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery...
May 14, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28495021/damage-control-and-intramedullary-nailing-for-long-bone-fractures-in-polytrauma-patients
#6
Peter Patka
The early fracture treatment in patients with multiple injuries should be focused on damage control. The fracture type and its location, local soft tissue condition as well as the patient's physiological condition shall determine the time and type of fracture treatment. Prevention of local and systemic complications must be immediately considered and included in the treatment planning. The use of external fixator (ExFix), which will be replaced by IM-implants in most cases at a later stage, provides adequate temporary fracture stabilization with less collateral damage...
May 7, 2017: Injury
https://www.readbyqxmd.com/read/28480184/trauma-surgery-without-proper-compensation-under-the-current-korean-national-health-insurance-system
#7
Kyoungwon Jung, Yunjung Heo, John Cook-Jong Lee, Mijin Lee, Suni Son, Hee Suk Park, Joo-Ok Kim, Jeong Hee Lee
PURPOSE: This study aimed to evaluate the situations and problems of the current health insurance fees for trauma surgeries. METHODS: We reviewed the medical records and billing data from trauma surgeries performed in the hospital from August 2012 to July 2014. The name and number of surgeries were investigated and the code and number of operations prescribed by surgeons were compared with the number of cases actually billed to insurance. In addition, the results returned by the Health Insurance Review & Assessment Services (HIRA) after deduction were investigated and compared to verify the insurance review findings...
May 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28446350/the-first-aid-and-hospital-treatment-of-gunshot-and-blast-injuries
#8
Axel Franke, Dan Bieler, Benedikt Friemert, Robert Schwab, Erwin Kollig, Christoph Güsgen
BACKGROUND: When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-threatening complications. METHODS: This review is based on pertinent publications retrieved by a selective search in Medline and on the authors' clinical experience...
April 7, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28424117/damage-control-surgery-and-the-management-of-a-cholecystocolic-fistula
#9
Patrick J Hunt, Gerry L Koons, Michael Murri, S Rob Todd
No abstract text is available yet for this article.
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28390649/abbreviated-closure-for-remote-damage-control-laparotomy-in-extreme-environments-a-randomized-trial-of-sutures-versus-wound-clamps-comparing-terrestrial-and-weightless-conditions
#10
Andrew W Kirkpatrick, Jessica Lynn McKee, Colonel Homer Tien, Anthony J LaPorta, Kit Lavell, Tim Leslie, Paul B McBeth, Derek J Roberts, Chad G Ball
INTRODUCTION: Far-Forward Damage Control Laparotomies (DCLs) might provide direct-compression of visceral hemorrhage, however, suturing is a limiting factor, especially for non-physicians. We thus compared abbreviated skin closures comparing skin-suture (SS) versus wound-clamp (WC), on-board a research aircraft in weightlessness (0g) and normal gravity (1g). METHODS: Surgeons conducted DCLs on a surgical-simulator; onboard the hangered-aircraft (1g), or during parabolic flight (0g), randomized to either WC or SS...
May 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28383477/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-tele-mentoring-tele-diagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#11
Andrew W Kirkpatrick, Jessica McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather Wright-Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of post-traumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or Resuscitative-surgery in austere-environments. Revolutions in technology for remote-mentoring of ultrasound and surgery may enhance capabilities to utilize the skill-sets of non-physicians. Thus, our Research-Collaborative explored remote-mentoring to empower non-physicians to address junctional and torso hemorrhage-control in Austere-environments...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28374115/damage-control-surgery-in-intracerebral-hemorrhage-in-acute-leukemia-a-review-of-two-cases
#12
Jaskaran Singh, Kanwaljeet Garg, Rajeev Sharma, Sumit Sinha, Shashank Sharad Kale
INTRODUCTION: Intracerebral hemorrhage is the second most common cause of mortality (after infections) in acute leukemia and is responsible for approximately 20% of deaths due to acute leukemia. Management of intracerebral hemorrhage (ICH) is mostly conservative but there exist certain patients who need emergent surgery due to the poor Glasgow Coma Scale (GCS) despite their coagulopathic state. CASE REPORT: We present here two such cases which were successfully managed with decompressive craniectomy which was done as a damage control surgery thus stating the importance of surgical intervention in the management of acutely deteriorating patients rather than the commonly employed conservative management due to their coagulopathic state...
April 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28243716/contemporary-damage-control-surgery-outcomes-80-patients-with-severe-abdominal-injuries-in-the-right-upper-quadrant-analyzed
#13
M Hommes, S Chowdhury, D Visconti, P H Navsaria, J E J Krige, D Cadosch, A J Nicol
BACKGROUND: Damage control laparotomy (DCL) is a well-established surgical strategy in the management of the severely injured abdominal trauma patients. The selection of patients by intra-abdominal organs involvement for DCL remains controversial. The aim of this study was to assess the injury to the abdominal organs that causing severe metabolic failure, needing DCL. METHODS: Severely injured abdominal trauma patients with a complex pattern of injuries were reviewed over a 52-month period...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28166165/automated-variable-aortic-control-versus-complete-aortic-occlusion-in-a-swine-model-of-hemorrhage
#14
Timothy K Williams, Lucas P Neff, Michael Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, John Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28162216/-gradient-treatment-of-acute-superior-mesenteric-venous-thrombosis-clinical-analysis-of-68-cases
#15
K Liu, X X Fan, S F Yang, W W Ding, C S He, X J Wu, J S Li
Objective: To investigate the effect of Gradient treatment for acute superior mesenteric venous thrombosis (ASMVT). Methods: Clinic data of 68 patients of ASMVT admitted in Department of General Surgery, Jinling Hospital, Medical School of Nanjing University from January 2009 to December 2014 were analyzed retrospectively. There were 50 male and 18 female patients with a mean age of (45±12) years. These patients were conducted by the stepwise treatment model (endovascular treatment-damage control surgery-surgical intensive care-intestinal rehabilitation treatment)...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28137537/randomized-controlled-trial-evaluating-the-efficacy-of-peritoneal-resuscitation-in-the-management-of-trauma-patients-undergoing-damage%C3%A2-control-surgery
#16
Jason W Smith, Paul J Matheson, Glen A Franklin, Brian G Harbrecht, J David Richardson, R Neal Garrison
BACKGROUND: Peritoneal resuscitation (PR) represents a unique modality of treatment for severely injured trauma patients requiring damage control surgery. These data represent the outcomes of a single institution randomized controlled trial into the efficacy of PR as a management option in these patients. STUDY DESIGN: From 2011 to 2015, one hundred and three patients were enrolled in a prospective randomized controlled trial evaluating the use of PR in the treatment of patients undergoing damage control surgery compared with conventional resuscitation (CR) alone...
January 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28133146/-damage-control-surgery-for-perforation-of-colon-cancer
#17
Takeshi Ebihara, Motohiko Yamada, Katsushu Simizu, Koji Amano, Masahiro Kawada, Genta Sawada, Yusuke Tsunetoshi, Ken Nakata, Akihiro Usui, Masaki Tujie, Yutaka Kimura, Satoru Munakata, Yasuki Nakata, Junya Fujita
Perforation due to colon cancer maycause peritonitis and septic shock. In these cases, we maynot be able to rescue the patients in spite of emergencysurgical intervention; in these conditions, owing to limitations of operation time, it is difficult for us to assess the state or extent of the disease and to perform an ideal oncological surgerywith dissection of lymph nodes. To overcome these limitations, we introduce the concept of "damage control surgery" developed in the trauma region to treat perforations of colon cancer...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28107224/abdominal-sepsis
#18
Quirine J J Boldingh, Fleur E E de Vries, Marja A Boermeester
PURPOSE OF REVIEW: To summarize the recent evidence on the treatment of abdominal sepsis with a specific emphasis on the surgical treatment. RECENT FINDINGS: A multitude of surgical approaches towards abdominal sepsis are practised. Recent evidence shows that immediate closure of the abdomen has a better outcome. A short course of antibiotics has a similar effect as a long course of antibiotics in patients with intra-abdominal infection without severe sepsis. SUMMARY: Management of abdominal sepsis requires a multidisciplinary approach...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28102530/surgeon-preparedness-for-mass-casualty-events-adapting-essential-military-surgical-lessons-for-the-home-front
#19
Kyle N Remick, Stacy Shackelford, John S Oh, Jason M Seery, Daniel Grabo, John Chovanes, Kirby R Gross, Shawn C Nessen, Nigel Rm Tai, Rory F Rickard, Eric Elster, C W Schwab
Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/27993357/amputation-not-a-failure-for-severe-lower-extremity-combat-injury
#20
Thijs T C F van Dongen, Eelco P Huizinga, Loes G M de Kruijff, Arie C van der Krans, Jochem M Hoogendoorn, Luke P H Leenen, Rigo Hoencamp
INTRODUCTION: The use of improvised explosive devices is a frequent method of insurgents to inflict harm on deployed military personnel. Consequently, lower extremity injuries make up the majority of combat related trauma. The wounding pattern of an explosion is not often encountered in a civilian population and can lead to substantial disability. It is therefore important to study the impact of these lower extremity injuries and their treatment (limb salvage versus amputation) on functional outcome and quality of life...
February 2017: Injury
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